My son-in-law is a ex-footballer... having played Canadian-style football in one of those men's house leagues for the guys who could never dedicate their lives to the game, but still had enough talent to make the provincial all-stars, or something similar. (Sidebar: the son-in-law used to play with one of the members of Kevin Martin's gold medal winning curling squad, who was the backup quarterback on their team!) As such, he had his fair share of injuries. One of them, the ubiquitous knee injury, has come back to haunt him. He recently had a MRI to work out the final diagnosis and build out a treatment strategy.
We got to babysit the granddaughter while they were at the diagnostic imaging unit. And, as the lad was leaving for the hospital, I made a pointed effort to impress on him the importance of filling out the questionnaire completely, and answering all questions honestly and completely.
And it is a good thing that he followed my advice.
When asked if he had ever had metal in his eyes, he thought about it, and replied that he had a bit of a 'challenge' at his part time job a couple of years ago that resulted in a metal sliver in his eye, which he self-extracted. (Young guys and their 'indestructible' attitudes; no safety glasses)
The radiology techs delayed the MRI and immediately did a medial head x-ray, and thought they saw 'something'. They then did a complete radial series (you know: the one where the machine head tracks from a point in line with your nose all the way around to the same point at the back of your head).
They discovered that the lad has a piece of metal lodged in his orbital socket. And, of course, it needs to come out.
It's a darned good thing that a) he told the whole truth, and b) that the MRI that was needed was only on his knee.
Sunday, February 28, 2010
Saturday, February 27, 2010
Medical Receptionists, please take note.
There's a certain cruelty in finding a message on your telephone answering machine when you get home on a Friday evening after a particularly odd day's business from the receptionist at your family doctor's office, especially when she has stammered her way through the message that they've received some test results and, if there has been no follow up from your oncologist, the doctor would like to see you in his office.
It's a Friday.
End of business.
Not open again until Monday.
No way to get in touch with her to ask for clarification, to ask which results from which test.
No way to get in touch with the doctor unless you wave the emergency flag. And even then there's another doctor on call this weekend who is not familiar with your case.
And your wife has hardly slept through the night, risen early on Saturday, and by 9 AM has determined not only the diagnosis, but what the prognosis is, and has announced it to both daughters.
And your eldest daughter is a nurse who is calling the house every fifteen minutes with updates on how she has been trying, unsuccessfully, to get the doctor's personal cell phone number, further freaking out your wife.
And the youngest daughter has decided that babysitting your grand daughter Saturday night may not be such a good idea anymore.
And your wife is having second thoughts about having friends for dinner on Sunday.
Cruel. Just plain cruel.
Just a word to the medical receptionists out there: please don't do this. If I leave you my cell number, please use it! Call me! Leave messages on my cell phone! Don't give my wife and children (drama queens, the bunch of them!) the excuse to wind themselves up. And for crying out loud, don't leave that sort of message on a Friday!
It's a Friday.
End of business.
Not open again until Monday.
No way to get in touch with her to ask for clarification, to ask which results from which test.
No way to get in touch with the doctor unless you wave the emergency flag. And even then there's another doctor on call this weekend who is not familiar with your case.
And your wife has hardly slept through the night, risen early on Saturday, and by 9 AM has determined not only the diagnosis, but what the prognosis is, and has announced it to both daughters.
And your eldest daughter is a nurse who is calling the house every fifteen minutes with updates on how she has been trying, unsuccessfully, to get the doctor's personal cell phone number, further freaking out your wife.
And the youngest daughter has decided that babysitting your grand daughter Saturday night may not be such a good idea anymore.
And your wife is having second thoughts about having friends for dinner on Sunday.
Cruel. Just plain cruel.
Just a word to the medical receptionists out there: please don't do this. If I leave you my cell number, please use it! Call me! Leave messages on my cell phone! Don't give my wife and children (drama queens, the bunch of them!) the excuse to wind themselves up. And for crying out loud, don't leave that sort of message on a Friday!
Friday, February 26, 2010
Avoid Dehydration -- Drink!
I must admit that I am probably the last person who should be talking about dehydration... I do not keep my fluid levels topped up properly at the best of times. During my cancer treatments I was even worse at it. In fact, while I was doing the combined radiation and chemo therapies the lead of my oncology team, Dr. Jha, finally got so frustrated with my inadequate fluid intake that he made taking two x one litre bags of fluid intravenously daily a mandatory requirement for the last two weeks of my radiation treatments. Now that was a bit embarrassing! Imagine taking up a bed for a couple of hours in a cancer treatment centre just because you can't be bothered to drink a couple of litres of water on your own. Okay, in my defense, I didn't want to take anything by mouth during that time period... hmmmm. Not much of a defense when my recovery was at risk.
Here's the advice: Drink. Drink WATER. And some juices, just being careful with which ones of those you choose. Apparently pineapple juice has properties that will undo all the good some medications will. You need to do the research, as in most situations during your treatments.
Why is dehydration such a big deal? Well, I don't quite understand all the ins and outs, but water is the major component in the body. It is the delivery system to the body's cellular structure. A lack of water, or dehydration can be responsible for depression, loss of libido, lupus flare ups, joint pain and a host of other things. Don't be complacent and dismiss this lightly: Dehydration can kill... there's something like 2.2 million children dying every year from the dehydration caused by diarrhoea. The elderly and the sick are equally at risk. You don't have to be lying prostrate in the desert sun somewhere to be seriously affected by a lack of water.
This goes back to my whining about knowing your body and what it is doing. You need to pay attention to what your body is telling you. For instance;
Arthritis: made worse by lack of water in your joints.
Heartburn: an indicator of a lack of water in the upper GI tract. Its a prime indicator that your body is headed for serious dehydration. The thing is that chemo therapy makes you so sick that you may miss that indicator.
Low Back Pain: can be an indicator that your spinal column and all that connective tissue needs a top up.
Heart Pain/Angina: indicating that your heart and lung tissues are not getting the water that they need.
Headaches (and Migraines): Think about the kind of headache that you get from a hangover, and you'll have a feel for it. You need to get some more water to the brain and eyes, and get more electrolytes back into your system.
Digestive tract pain: colitis-like symptoms, constipation can be caused by dehydration.
Diabetes: adult onset diabetes can be triggered by extended periods of dehydration. The body uses water as a delivery vehicle for insulin to cells.
High Cholesterol: indicator of potential hydration issues.
High blood pressure: hypertension can be a simple case of dehydration. Hypo tension means that you are usually in serious trouble.
I know that it's tough to drink, let alone eat, when you're dealing with the pain in your mouth and throat when you swallow, and the nausea from the chemo, and those indescribable sensations in your mouth from the radiation, but you really do need to stay hydrated. Drink water. Drink some of those better sports drinks that replenish salts and electrolytes. Take a look at the list above. How many of those things are going to be masked by the effects of your treatments? If you're really having trouble with getting your fluids down, raise the red flag with your treatment team before they find symptoms of potentially dangerous side effects to dehydration.
Here's the advice: Drink. Drink WATER. And some juices, just being careful with which ones of those you choose. Apparently pineapple juice has properties that will undo all the good some medications will. You need to do the research, as in most situations during your treatments.
Why is dehydration such a big deal? Well, I don't quite understand all the ins and outs, but water is the major component in the body. It is the delivery system to the body's cellular structure. A lack of water, or dehydration can be responsible for depression, loss of libido, lupus flare ups, joint pain and a host of other things. Don't be complacent and dismiss this lightly: Dehydration can kill... there's something like 2.2 million children dying every year from the dehydration caused by diarrhoea. The elderly and the sick are equally at risk. You don't have to be lying prostrate in the desert sun somewhere to be seriously affected by a lack of water.
This goes back to my whining about knowing your body and what it is doing. You need to pay attention to what your body is telling you. For instance;
Arthritis: made worse by lack of water in your joints.
Heartburn: an indicator of a lack of water in the upper GI tract. Its a prime indicator that your body is headed for serious dehydration. The thing is that chemo therapy makes you so sick that you may miss that indicator.
Low Back Pain: can be an indicator that your spinal column and all that connective tissue needs a top up.
Heart Pain/Angina: indicating that your heart and lung tissues are not getting the water that they need.
Headaches (and Migraines): Think about the kind of headache that you get from a hangover, and you'll have a feel for it. You need to get some more water to the brain and eyes, and get more electrolytes back into your system.
Digestive tract pain: colitis-like symptoms, constipation can be caused by dehydration.
Diabetes: adult onset diabetes can be triggered by extended periods of dehydration. The body uses water as a delivery vehicle for insulin to cells.
High Cholesterol: indicator of potential hydration issues.
High blood pressure: hypertension can be a simple case of dehydration. Hypo tension means that you are usually in serious trouble.
I know that it's tough to drink, let alone eat, when you're dealing with the pain in your mouth and throat when you swallow, and the nausea from the chemo, and those indescribable sensations in your mouth from the radiation, but you really do need to stay hydrated. Drink water. Drink some of those better sports drinks that replenish salts and electrolytes. Take a look at the list above. How many of those things are going to be masked by the effects of your treatments? If you're really having trouble with getting your fluids down, raise the red flag with your treatment team before they find symptoms of potentially dangerous side effects to dehydration.
Wednesday, February 24, 2010
Another CT Scan
We're now twenty-seven months out from the original cancer surgery. We've quietly slipped by the 2nd anniversary for the start of the courses of radiation and chemotherapy.
This morning I had a CT scan of my neck and chest, complete with the dye injection, and a standard chest x-ray. This really doesn’t have that much to do with my cancer history directly, but rather it is a reaction to an ongoing problem that I seem to have developed. I am suffering from a form of gastroesophageal reflux, which is when the contents of your stomach rise back up your esophagus at inconvenient times, like when you burp, or when you lay down, or when you’re eating; the esophagus suddenly spasms, hiccup-like. Well, it is not so much ‘suffering’ from it as being inconvenienced by it. I am using a generic version of the drug Previcid (lansoprazole) to slow or control the production of stomach acid, so I really don’t feel the burning sensation that the stomach acids should be causing. And, for the most part, the 'events' are happening while I sleep. I keep a little book of all of my physical idiosyncracies and have documented several reflux events where it woke me from my sleep. But the real indicator that made the doctor suggest the CT scan is an on-again, off-again cough, a little throat clearing sort of cough: annoying because it is not quite a hearty phlegm clearing hack, but too much to be a tickle that can be placated with a drink or a lozenge.
To his credit, the good doctor didn’t try to bombard this symptom with another type of drug to try to make it go away.
Dr. William's main concern is that the overnight backup may be damaging the epiglottis. It's time to just have a look to see what’s happening in that area.
He has suggested that results of the CT will either put the subject to rest and we’ll just keep using the Pervacid/lansoprazole, or have me scurrying off to a pulmonary specialist. I still don’t understand why this is in the realm of the pulmonary docs, but apparently it is.
Now the unspoken stuff that goes along with gastroesophageal reflux is that it can be a precursor to a laundry list of ailments which is topped off with esophageal carcinoma. And, of course, now that I have a demonstrated predisposition to the squamous cell variety, I really think that he’s being quietly prudent in his investigation: he didn't come right out and say what he's looking for. The other unspoken correlation is between celiac disease and esophageal cancers.
Oh, aren’t we just having so much fun!
The actual appointment went brilliantly… a little bit of a delay, but it wasn’t really significant enough to mention. The ladies who looked after me were stellar examples of nursing and radiological staff; buoyant, chatty, fun, and generally happy. I was complimented on my glasses, and on my cologne. It wasn’t quite flirting, but the interest in me, rather than the affliction, felt good.
This morning I had a CT scan of my neck and chest, complete with the dye injection, and a standard chest x-ray. This really doesn’t have that much to do with my cancer history directly, but rather it is a reaction to an ongoing problem that I seem to have developed. I am suffering from a form of gastroesophageal reflux, which is when the contents of your stomach rise back up your esophagus at inconvenient times, like when you burp, or when you lay down, or when you’re eating; the esophagus suddenly spasms, hiccup-like. Well, it is not so much ‘suffering’ from it as being inconvenienced by it. I am using a generic version of the drug Previcid (lansoprazole) to slow or control the production of stomach acid, so I really don’t feel the burning sensation that the stomach acids should be causing. And, for the most part, the 'events' are happening while I sleep. I keep a little book of all of my physical idiosyncracies and have documented several reflux events where it woke me from my sleep. But the real indicator that made the doctor suggest the CT scan is an on-again, off-again cough, a little throat clearing sort of cough: annoying because it is not quite a hearty phlegm clearing hack, but too much to be a tickle that can be placated with a drink or a lozenge.
To his credit, the good doctor didn’t try to bombard this symptom with another type of drug to try to make it go away.
Dr. William's main concern is that the overnight backup may be damaging the epiglottis. It's time to just have a look to see what’s happening in that area.
He has suggested that results of the CT will either put the subject to rest and we’ll just keep using the Pervacid/lansoprazole, or have me scurrying off to a pulmonary specialist. I still don’t understand why this is in the realm of the pulmonary docs, but apparently it is.
Now the unspoken stuff that goes along with gastroesophageal reflux is that it can be a precursor to a laundry list of ailments which is topped off with esophageal carcinoma. And, of course, now that I have a demonstrated predisposition to the squamous cell variety, I really think that he’s being quietly prudent in his investigation: he didn't come right out and say what he's looking for. The other unspoken correlation is between celiac disease and esophageal cancers.
Oh, aren’t we just having so much fun!
The actual appointment went brilliantly… a little bit of a delay, but it wasn’t really significant enough to mention. The ladies who looked after me were stellar examples of nursing and radiological staff; buoyant, chatty, fun, and generally happy. I was complimented on my glasses, and on my cologne. It wasn’t quite flirting, but the interest in me, rather than the affliction, felt good.
Wednesday, February 03, 2010
Hey, you! Get your H1N1 flu shot... stop being a dink about it!
At approximately 0800 on February 4, 2010 doctors will be taking a twenty-four year old woman of east Indian descent off life support. Her parents have arrived from Toronto, her brother from Calgary. This lovely young woman, one of our acquaintances, has no brain activity; her kidneys failed her, her lungs stopped functioning effectively, and then her heart stopped.
At this time they haven't told anyone what is responsible, but the chatter going around is that it started off with a bout of H1N1. There will likely be an autopsy...
H1N1 kills.
Get your damned shots.
At this time they haven't told anyone what is responsible, but the chatter going around is that it started off with a bout of H1N1. There will likely be an autopsy...
H1N1 kills.
Get your damned shots.
Tuesday, February 02, 2010
Americans kidnapping Haitian children?
In the aftermath of the Haitian earthquake a group of ten fundamentalist Baptist American do-gooders snuck across the border from the Dominican Republican, convinced temporary and permanent caregivers (including the parents!) of 33 Haitian children to allow the children to be loaded onto a bus and driven out of Haiti. The caregivers, and even the children believed that they were going off to 'summer camp' or to 'boarding school'... based on flyers/leaflets that the team of ten were passing out. But also within their possession where other flyers that detailed their goal to remove 100 children from Haiti and take them first to the Dominican Republic, and then back to the US for adoption. Not all the children were orphans...
At this point there is growing debate over what to do about the ten Americans. My answer is simple; jail them. If they are part of a child trafficking organization, then they deserve to be incarcerated. If they are simply arrogant Americans discounting the laws of Haiti, then they deserve to do time to teach them respect for another nations' laws and people. If they are simply mis-guided, over-zealous Christian fundamentalists, they need to spend time in jail to learn some humility. And if they are simply do-gooders who never considered the implications of their actions, then they need to spend time behind bars reflecting on their collective stupidity.
At this point there is growing debate over what to do about the ten Americans. My answer is simple; jail them. If they are part of a child trafficking organization, then they deserve to be incarcerated. If they are simply arrogant Americans discounting the laws of Haiti, then they deserve to do time to teach them respect for another nations' laws and people. If they are simply mis-guided, over-zealous Christian fundamentalists, they need to spend time in jail to learn some humility. And if they are simply do-gooders who never considered the implications of their actions, then they need to spend time behind bars reflecting on their collective stupidity.
Yesterday's lab tests...
This is another one of those posts where all I'm really trying to say is that I am so lucky to be looked after by the Canadian health care system in Alberta.
Yesterday at noon I managed to get out of the office, get to a local lab where I had made an appointment, had my blood taken, walked across the parking lot to the medical imaging clinic, and, without an appointment, had the x-rays of my right thigh done. I was back online, working, within one hour. And it cost me nothing more than my monthly healthcare premiums and time. Oh, wait... This is Alberta. There aren't any healthcare premiums!
The blood work ordered included 'general chemistry' which apparently covers sodium, potassium, chloride and CO2. I have no idea why Dr. Williams needs to see that stuff... but hey, he's the doctor. He also ordered a test of the creatinine in my blood as a way to check kidney function prior to having a chest CT scan done. Why? Well, if the kidneys are not functioning at optimal levels, they can't give you any of the dyes, which may/may not diminish the usefulness of the scan.
And as a hedge, the doctor ordered a TSHB (TSH progressive testing) test just to ensure that the thyroid levels are where they need to be...
The x-ray was a truly wonderful thing: a walk-in experience that took half an hour from walking in the front door, to walking out again. The lab I used, which happens to be the lab that did the ultrasound on my neck which started this ride in the summer of 2007, has gone almost completely 'digital'. There is no x-ray film. There are sensors build into the x-ray table which convert the radiation bombardment into video/computer imagery. The somewhat lively x-ray technician who took the shots of my knee/thigh/hip told me that it was actually possible that the results of the x-ray would be on my doctor's computer desktop before I managed to get dressed and get back onto the street.
And once again, I have no complaints about how I am being handled in the healthcare system.
Yesterday at noon I managed to get out of the office, get to a local lab where I had made an appointment, had my blood taken, walked across the parking lot to the medical imaging clinic, and, without an appointment, had the x-rays of my right thigh done. I was back online, working, within one hour. And it cost me nothing more than my monthly healthcare premiums and time. Oh, wait... This is Alberta. There aren't any healthcare premiums!
The blood work ordered included 'general chemistry' which apparently covers sodium, potassium, chloride and CO2. I have no idea why Dr. Williams needs to see that stuff... but hey, he's the doctor. He also ordered a test of the creatinine in my blood as a way to check kidney function prior to having a chest CT scan done. Why? Well, if the kidneys are not functioning at optimal levels, they can't give you any of the dyes, which may/may not diminish the usefulness of the scan.
And as a hedge, the doctor ordered a TSHB (TSH progressive testing) test just to ensure that the thyroid levels are where they need to be...
The x-ray was a truly wonderful thing: a walk-in experience that took half an hour from walking in the front door, to walking out again. The lab I used, which happens to be the lab that did the ultrasound on my neck which started this ride in the summer of 2007, has gone almost completely 'digital'. There is no x-ray film. There are sensors build into the x-ray table which convert the radiation bombardment into video/computer imagery. The somewhat lively x-ray technician who took the shots of my knee/thigh/hip told me that it was actually possible that the results of the x-ray would be on my doctor's computer desktop before I managed to get dressed and get back onto the street.
And once again, I have no complaints about how I am being handled in the healthcare system.
Subscribe to:
Posts (Atom)